Background: Incarcerated adolescents within the juvenile justice system are more likely to be diagnosed with poor mental health compared with their non-incarcerated peers. Conducting clinical trials on mental health interventions among an incarcerated adolescent population is challenging due to the nature of detention facilities. Objectives: This systematic review examines available literature on Randomized Clinical Trials (RCT) done to assess mental health interventions among incarcerated adolescents globally and to determine the type of intervention that would best work in this setting. In this study, a systematic review was conducted to search, identify, and recommend effective interventions best suited to preserve and improve the mental wellbeing of incarcerated adolescents within the detention institution setting. Method: The search was performed in Medline via Ovid, Cochrane Library, Scopus, and Web of Science databases to retrieve related publications released between 1970 and March 2021. The principal inclusion criteria were RCT articles issued in English that reported any mental health interventions performed in juvenile detention centers involving delinquent adolescents aged 10 to 19 years old. Results: The search discovered 10 related articles that fulfilled the required inclusion criteria. In total, there were seven different types of mental health interventions used in all the studies. The three major themes identified among the selected studies are the interventions for coping strategies, risky behavior, and attention disorder among incarcerated adolescents. The efficacy of the interventions was dependent on the level of intelligence, duration of incarceration, risk of treatment diffusion, and depression symptoms among incarcerated adolescents. Conclusions: Cognitive behavioral therapy (CBT) intervention that is simple, brief, unique, and targets depressive symptoms, has the potential to be most efficacious in improving mental health among incarcerated adolescents.

Background: COVID-19 is one of the most challenging and devastating public health emergencies we have experienced in our lifetimes. There is a growing concern that the pandemic and its imposed public health restrictions may be harming a generation of young people. This article concerns child and adolescent psychiatry as there is already a mismatch between resources and demand. Method: This paper will outline the day to day working challenges encountered by the SPMHS adolescent service, staff, and patients in the initial months of the COVID-19 crisis and some of the strategies implemented to deal with these. Discussion: In St. Patrick’s University Hospital in Ireland, significant challenges in the adolescent service were encountered in the initial months of the COVID-19 crisis. These included the cessation of face-to-face patient interactions, therapeutic leave and visiting restrictions, school closure, social restrictions, difficulties in organizing medical appointments and investigations, family stress and increased workload for staff. Strategies including telepsychiatry have enabled the delivery of an efficient and accessible adolescent service during this crisis. Conclusion: Future research is required to analyse how best we can support children and adolescents during COVID-19, particularly those with existing mental illness is crucial.

Objective: The journey into adulthood is a critical phase of profound psychological and social change, especially for children with long-term care needs, including those with Intellectual Disability (ID). : In this paper, we aim to describe the clinical picture of patients with mild to profound ID during the transition from childhood to adulthood. Method: We explored the prevalence of all comorbidities in 53 patients with mild to profound ID before and after transition. We collected information on the services taking care of the person at the time of follow up and about the actual occupation, if any. Results: Out of the whole sample of patients, 79% were in touch with an adult health service after transition and about one fifth required care from more than one institution. 81% were currently employed in centres managed by health services. The distribution of main diagnosis and comorbidities both changed (χ2(1, n=42)=116.7; p<.001 and χ2 (1, n=42)=267.4; p<.001, respectively) after the transition to adulthood. Transition to adulthood was characterized by the emergence, as main diagnosis, of psychiatric disorders, as well as by a slight increase of frequencies of comorbidities. Conclusions: After transition from childhood to adulthood a change in epidemiology was observed. This may reflect a clinical evolution or a discontinuity in the use of diagnostic labels between paediatric and adult committed services. We propose suggestions for better management of the transition phase.

Background: Adolescents and parents often disagree about the perception of bullying victimization since adults tend to underestimate its occurrence. Objective: This study identifies factors that can influence maternal perception of bullying victimization experienced by her son/daughter in the past 12 months. Methods: This cross-sectional study involved a representative sample of in-school adolescents (n=669, 11-15-years) living in Itaboraí city, Brazil (mean age±SE: 13.01±0.07 years; 51.7% females). A 3-stage probabilistic sampling procedure (random selection of census units, eligible households and target child) generated sampling weights. Trained lay interviewers individually applied semi-structured questionnaires to mothers and adolescents in the households. Multivariable logistic regression analysis examined factors potentially influencing maternal perception of bullying victimization experienced by her son/daughter: adolescent gender and age, adolescent self-perceived bullying victimization, exposure to severe physical punishment by parents, internalizing/externalizing behaviour problems identified by the Youth Self-Report/YSR, maternal education and maternal anxiety/depression identified by the 20-item Self-Reporting Questionnaire/SRQ-20. Results: Univariable logistic regression analysis identified a strong association between adolescent self-perceived bullying victimization and maternal perception of bullying victimization experienced by her son/daughter. Multivariable models showed that adolescent perception influenced maternal perception when adolescents had no clinical internalizing behaviour problems and when mothers had higher education. Conclusion: Anxious/depressive adolescents may hide victimization incidents, while those with no problems probably reveal these incidents to the mother. Considering that maternal low education is an indicator of low socioeconomic status, which is associated with multiple stressors, less educated mothers may be more likely to interpret these incidents as a common part of growing-up.

Background:By the year 2020, children of color will become the majority of those 18 years of age and under in United States. There is a dearth of research that investigates the developmental trajectories of children of color, especially those who live in communities where they are exposed to traumatic events. African American males reared in poverty and/or living in violent communities are an especially vulnerable group.Methods:This paper examines the unique experiences of Black male adolescents and their emotional, psychological, and neurobiological responses to trauma.Discussion:Trauma has multifaceted effects on the lives of Black males. Behavioral disturbances can result in exclusion from school, leading to further traumatization and deprivation. Much of what appears to be antisocial behavior is in fact adaptive response to living in violent communities. It is important to consider the role of this complex interweaving of circumstances in understanding the development of this vulnerable group.

Background: Few studies on gender-based diagnostic characteristics of adolescent suicide attempters in emergency departments (EDs) have included individuals with autism spectrum disorder (ASD). Objective: This study aimed to examine the clinical features of adolescent suicide attempts in EDs, focusing on gender differences and considering individuals with ASD. Method: Ninety-four adolescent patients, aged less than 20 years, who had attempted suicide and had been hospitalized in an emergency department, participated in this study. Psychiatric diagnoses according to DSM-IV criteria and clinical features were compared between male and female patients. Results: The number (%) of males was 15 (16.0), and that of females was 79 (84.0). The mean age (SD) of males was 17.1 (1.5), and that of females was 16.9 (1.6). The attempt methods were more serious, length of stay in the emergency room longer, and rate of outpatient treatment lower in males. In addition, suicide attempters with ASD were significantly more frequent in male. Adjusting for age and gender, adjustment disorder was significantly associated with the presence of suicide attempters with ASD using a multivariable logistic regression. Conclusion: Males were less likely to visit psychiatric service previous to attempting suicides, and may be likely to complete suicides. In addition, suicide attempters with ASD are characteristic in male, and likely to have comorbid adjustment disorder. ED visits offer a window of opportunity to provide suicide prevention interventions for adolescents, and therefore, psychiatrists in EDs have a crucial role as gatekeepers of preventing suicide reattempts, especially in adolescent males including individuals with ASD having adjustment disorder.

Background: While practice parameters recommend assessment of conscience and values, few resources are available to guide clinicians. Objective: To improve making moral inquiry in youth aged 15 to 24. Method: After documenting available resources for behavioral health clinicians who are inquiring about their patient’s moral life, we consider our studies of conscience development and functioning in youth. We align descriptions of domains of conscience with neurobiology. We compare youth reared in relative advantage, who have fairly smooth functional progressions across domains, with youth reared in adverse circumstances. We offer the heuristic conscience developmental quotient to help mind the gap between conscience in adversity and conscience in advantage. Next, we consider severity of psychopathological interference as distinct from delay. A case illustration is provided to support the distinction be Results: Our findings support the hypotheses that youth who experience adverse childhood experiences show evidence of fragmentation, unevenness and delay in their conscience stage-attainment. We demonstrate proof of concept for conscience sensitive psychiatric assessment in the youth-span. Conscience sensitive inquiries improve upon merely conscience relevant interpretations by affording better appreciation of moral wounding, in turn setting the stage for moral-imaginative efforts that elicit and make the latent values of the youth more explicit. Conclusions: A conscience sensitive approach should be part of both psychiatric and general medical education, supported explicitly by clinical guidelines recommending conscience sensitive interview techniques that aim to acquire information aligned with current neurobiological terminology.